Doylestown Health Busts Prostate Cancer Myths

In honor of June, Men’s Health Month, Albert Ruenes, MD, a Doylestown Health urologist, clears up popular misconceptions about prostate cancer, the second most common cancer among men in the United States:

Myth #1 Prostate Cancer always has symptoms. FALSE

The vast majority of men that we diagnose in this practice with prostate cancer have no symptoms at all. If a man is symptomatic, it’s generally a sign that the cancer is locally advanced and probably beyond the extent of the prostate itself. Men should have their prostate exam and a blood test or at least have that discussion with their healthcare provider.

Myth #2 Prostate Cancer only develops in elderly men. FALSE

In fact, the most aggressive prostate cancers occur in younger men. In our practice, we recommend that men over the age of 50 have a discussion about the virtues of screening for prostate cancer with their health care provider. If men have a strong family history of prostate cancer, if they are African American, we suggest that they start that discussion at age 45. At Doylestown Health, we do treat men in their late forties and early fifties for prostate cancer.

Myth #3 Prostate Cancer will always cause erectile dysfunction. FALSE

A valid concern of all men who are facing the need for some form of prostate cancer treatment is that after radiation therapy or surgical removal of the prostate, urinary habits and sexual function can be compromised. There are ways to avoid those potential hazards of treatment, particularly if the cancer is caught early. The earlier a cancer is diagnosed, the more successful treatment is and often times, the less significant the side effects of treatment are.

Myth #4 Prostate Cancer is only a concern if you have a family history. FALSE

One man in seven will develop prostate cancer in his lifetime. It’s the male equivalent of breast cancer. So, while a family history increases risk, it by no means is the only factor that would push you toward screening. The general population, based on those numbers, deserves screening.

Myth #5 An enlarged prostate is always the result of cancer. FALSE

Prostate enlargement, or a condition called benign prostatic hypertrophy, is independent of prostate cancer. Prostate size has no bearing on the probability of a prostate being malignant or benign.

Myth #6 The PSA screening is the definitive test used to diagnose prostate cancer. FALSE

Prostate Specific Antigen (PSA), which looks for a tumor marker specific to the prostate, is the best screening blood test available. But unfortunately, it’s not an ideal test. An ideal test would always be abnormal in the presence of cancer and normal in the absence of cancer. PSA is not that clean. Many men who have elevated PSA will never have prostate cancer, and some men have prostate cancer despite a normal PSA. So, PSA has to be used as a part of the evaluation. PSA can become a more valuable indicator if we have a history of a man’s PSAs. That’s why screening early is also important, so that we can establish a trend. Then we can glean some information if all of a sudden, a PSA starts to change.

Myth #7 Prostate cancer always requires immediate treatment. FALSE

Once the diagnosis of prostate cancer is established by biopsy, we gain information about how aggressive that particular cancer is. Not every man’s prostate cancer is the same. Some men have very slow-growing cancers that we characterize as low-risk. Often times, low-risk prostate cancer can be surveilled, doesn’t require treatment at all, but requires close monitoring. Men with average risk of prostate cancer who are contemplating therapy often have several months to research certain options, obtain second opinions and then develop their care plan. Only the most aggressive types of prostate cancers require urgent treatment. And that treatment can be a combination of therapies.

Dr. Ruenes adds that recent advances in prostate cancer diagnosis, for example with the use of 3T MRI at Doylestown Hospital, have yielded more specific insight into a patient’s prostate cancer and the best treatment options. He also cites dramatic, life-prolonging improvements in medical oncology over the past five to ten years.